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Apthous ulcers

Painful, shallow ulcers with an erythematous halo located on non-keratinized oral mucosa, unlike the painless mucous patches of syphilis.

Bowenoid papulosis

Presents as multiple, reddish-brown or violaceous papules in the anogenital region, histologically a form of carcinoma in situ associated with HPV.

Discoid eczema

Coin-shaped, intensely pruritic, eczematous plaques, which are not typical of the non-pruritic, papulosquamous rash of syphilis.

Drug eruption

A morbilliform rash that is typically more pruritic and widespread, with a clear history of a new medication, and lacks palm/sole involvement.

Folliculitis

Presents as pustules centered on hair follicles, whereas syphilitic folliculitis causes 'moth-eaten' alopecia without prominent pustulation.

Genital warts

Exophytic, cauliflower-like papules in the anogenital region caused by HPV, unlike the flat, broad, and moist condyloma lata of syphilis.

Guttate psoriasis

Characterized by small, 'drop-like' salmon-pink papules with a fine scale, often triggered by a streptococcal infection.

Hand foot and mouth disease

A viral illness causing vesicles on the hands, feet, and in the mouth, typically in young children, unlike the papulosquamous eruption of syphilis.

Lichen planus

Distinguished by its pruritic, purple, polygonal papules, often with Wickham's striae, a different morphology and color than syphilitic papules.

Pityriasis lichenoides chronica

Presents as crops of small, reddish-brown papules with an adherent 'mica-like' scale that can be scraped off, typically on the trunk.

Pityriasis rosea

Begins with a single 'herald patch' followed by a generalized eruption of oval, pink papules with fine scale in a 'Christmas tree' distribution on the back.

Squamous cell carcinoma

Can present as non-healing genital ulcers (chancre-like) but are typically solitary and indurated, and biopsy confirms malignancy.

Viral exanthem

A generalized maculopapular rash that is typically more transient and associated with acute viral symptoms, and rarely involves the palms and soles.

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